Update in multiple sclerosis treatment.

The treatment of múltiple sclerosis (MS) has experienced an important change in the last decade, once it has been demonstrated that several drugs could modify the evolution if this disease. In the recent years, several papers have offered some new knowledge and therapeutic possibilities. In this article we review the current pharmacological treatment for MS, for the acute bouts, for preventing evolution and for its symptoms.

For the acute bouts, steroids continue to be the usual therapy, even though they are used in variable protocols. Plasma exchange can be an alternative for those patients who do not respond to steroids.

Beta-interferons or glatiramer are considered as the drugs of choice for the prevention of evolution of active forms of remitting-recurrent MS, with azatioprine being the second option. For non-responders with aggressive clinical course mitoxantrone or drug associations can be used. In those cases with a first demyelinating episode with MRI highly suggestive of MS BETA-interferon 1a can be indicated. In those cases with severe clinical course mitoxantrone can be an alternative.

There is no efficacious and safe preventive treatment for those patients with primary progressive forms for MS. Finally, symptomatic treatment is very important for the majority of MS patients. Even though this treatment can improve the quality of life of our MS patients, it is frequently forgotten by the clinicians. We review the current possibilities for the usual MS symptoms.

Neurología 2004;19(Supl 2):8-21